The science of virusesvirology


Can Lean Thinking Save our Healthcare System?

That is a very good question.medical clinics. Patients travel from
I am not sure any one thing will 'save'one site, queue up and after being
healthcare. We are in a time of 'white'processed' in that department are sent
water' change in medicine. Newto another department. Thus for a 2
discoveries and new treatments race tominute blood test, 5 minute radiograph
the bedside. There will instead be aof the chest and a 10 minute doctor's
constellation of things that willvisit the patient may have spent all day
improve our healthcare systems. Thego to and from these functional
future of medicine is in the provisionvillages. The clinics of the near future
of personalized medicine. This isshould be organized into a "cellular"
typically discussed in relationship tomodel which will allow all the services
the Humane Genome project and molecularto take place within the clinic, rather
medicine. However, it is much more thanthan this functional "village' model
that.where patients travel between functions
Personalized medicine is providing thesuch as lab, clinic and radiology. In
'right care at the right time'. Often inthe future those functions will be
the management of chronic conditionsprovided at the point of care.
care is arranged 'just in case'.Personalized medicine will become the
Appointments are scheduled into the'right care, at the right time, in the
future 'just in case' you need to beright place'.
seen. This is a symptom of the traditionLean Thinking in healthcare is not just
of medicine that dictated care to theabout how to reduce the administrative
patient rather than negotiated care withburden or waiting times of the patient.
the patient. Personalized medicine willIt is also important to consider the
change our healthcare processescosts that patients undergo in accessing
dramatically in the future. Personalizedservices. Even if the patient does not
medicine will require our systems topay personally for their care, there is
provide 'customized' solutions fora cost. Much of that cost is hidden and
patients. Medications are chosen baseddoes not occur in the clinic or
on a genetic analysis of the patient.hospital. It occurs as a result of the
Other patient needs will also becometime and effort to get to the hospital
important to meet. After hours clinicsor clinic. An easy illustration is
already seek to personalize care.trouble a patient undergoes in traveling
Patients will be able to request or pullto the office, finding a parking place,
services without long queues. Somethen walking to the office and then
systems already allow patients to gorepeating at the other 'villages'. The
online and select their appointment timetravel costs represent a barrier to many
without ever speaking to a clerk. Theof our patients. Technology solutions
services they pull will be those thatwill allow an amendment to the mantra of
have value for them. Lean will provide'right care at the right time' by
the basis for understanding the valueproviding care at a distance.
added activities that will composeTelemedicine and telehealth combined
personalized medicine.with point of care testing will be a
Lean Thinking is directed at reducingnorm. This will move medicine away from
waste. This will allow a greaterthe bricks and mortar of the clinic and
productivity for those value addedhospital. The mantra will become 'the
services. For this reason managementright care, at the right time, in the
science will be as important as basicright place, using the right
sciences in the healthcare of thetechnology.'
future. So called 'implementationLean thinking actually challenges
science' or 'translational science' ishealthcare administrators to develop
little more than systematically applyingsystems that provide 'the right care, at
management theory in the delivery ofthe right time, in the right place using
evidenced based practices. Currently itthe right technology.' By applying Lean
has been estimated that approximatelyThinking as new services and buildings
50% of a clinician's time is notare considered all of this is possible
necessary and not value added in thetoday. The future is here. But it will
eyes of the patient. If this waste istake administrators and physician
eliminated then clinician's will be ableexecutives prepared to think lean to
to spend more of their time caring forfully capitalize on the changes. So you
patients. This will reduce frustrationcould say that Lean Thinking will be as
for both clinician and patient.important to 'saving' healthcare as any
Currently most facilities are organizedadvance in the biological sciences might
around functional department such asbe.
laboratory testing, radiology, and



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